The relationship between contact with peers and self-stigma in people with mental illness

Abstract

ABSTRACT Public and self- mental health stigma have deleterious effects on the lives of people with mental illness (PWMI). Researchers have developed multiple interventions to reduce public stigma against this group, but little attention has been given to reducing self-stigma in spite of its closer association with adverse outcomes. There is some preliminary evidence suggesting that a strategy commonly used to address public stigma – contact with PWMI – may also reduce self-stigma in people with mental illness. However, the limitations of these studies necessitate a more rigorous examination. While overcoming the limitations of previous studies, we aimed to determine whether peer contact could represent an effective strategy for reducing self-stigma in PWMI. We recruited 991 participants with mental illness who reported their frequency of contact with other PWMI, frequency of contact with people without mental illness, self-stigma (the degree to which participants agreed with and applied common stereotypes about mental illness to themselves), and harm to self-respect, self-esteem, and self-efficacy. We tested a serial mediation model controlling for contact with people without mental illness. Consistent with hypotheses, more frequent peer contact was associated with reduced harm to self-respect and higher self-esteem and self-efficacy through lower agreement with stereotypes and lower self-application of stereotypes. The results suggest that peer contact may represent a viable strategy for reducing self-stigma and improving self-concept in PWMI. This substantially expands the usefulness of existing intergroup contact strategies and supports the development of an alternative, non-clinical intervention for reducing self-stigma. Future research should clarify the direction of the effect and investigate the nature of peer interactions in order to inform interventions.